Negative Appendectomy Rate: Can It Be Reduced?

OBJECTIVE: The objectives of this study were to calculate the current negative appendectomy rate and to determine the predictive value of ultrasonography in patients having suspicion of acute appendicitis. DESIGN: This is a prospective analytical study of patients admitted with suspicion of acute appendicitis and underwent appendectomy. PLACE & DURATION OF STUDY: This study was conducted at Isra University Hospital, Hyderabad from January 2003 to December 2006. PATIENTS & METHODS: The data of all adult patients (above 14 years of age) admitted from emergency room with suspected acute appendicitis and underwent appendectomy were collected prospectively. These data were analyzed to calculate the negative appendectomy rate as well as the positive and negative predictive values of ultrasonography. RESULTS: In all, 195 patients fulfilled the inclusion criteria during the above mentioned period. The overall negative appendectomy rate was 12.3%. The positive and negative predictive values of ultrasonography for appendicitis were 100% and 85.7% respectively. The sensitivity and specificity of ultrasonography for appendicitis were 97.6% and 100% respectively. CONCLUSION: The negative appendectomy rate at Isra university Hospital Hyderabad is comparable to the rates reported in the local as well as international literature. The preoperative ultrasonography is an essential tool for reduction of negative appendectomy rate.